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Urology
Hydrocoele
Collection of fluid in the tunica Vaginalis
Types
Congenital
Due to patent processes vaginalis
Sub types
Vaginal hydrocoele- only around the scrotum (sac)
Infantile hydrocoele- till the external ring
True congenital hydrocoele- connection with peritoneum
Encysted-Appears like a small cyst at the root.
Hydrocoele en bissac- has connection with an abdominal sac.
Acquired.
Primary vaginal hydrocoele
Young or middle age
1.Due to increased secretion
2.Due to defective lymphatic drainage
Clinical features
Localized to scrotum, Cystic, transillumination positive, get above the swelling present.
Fluid- serous - albumin fibrinogen.
Secondary vaginal hydrocoele
Epididymo orchitis
1.Tuberculosis
2.Filariasis - recurrent, liquid fat
Tumor
Pyocoele- infection on an pre existing hydrocoele.
Hematocoele
Feature -transillumination negative
Also negative in thick tunical vaginalis
Treatment
1.Plication (making folds)- "Lords plication" done for small hydrocoele, tunica vaginalis is cut and plicated to tunica albugenia fluid is drained by lymphatics.
2.Partial excision and eversion, it is sutured to the back of testis.
3.Aspiration
Complication
Hematocoele
Pyocoele
Calcification
Rupture
Hernia of the sac
